This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. The effects of neonatal pain may result in physiological, hormonal and behavioral reactions that persist into adulthood and may cause functional disorders that are refractory to conventional medicine. Treatments to decrease the effects of neonatal pain have not been adequately researched and existing ones are used capriciously. Therefore, effective pain management and pre-emptive interventions with low side effect profiles are needed. These pre-emptive techniques include skin-to-skin contact with the neonate (kangaroo care), facilitated tucking and suckling sugar-coated pacifiers. In this application, we propose to evaluate the effectiveness and mechanism of action of pre-emptive care to prevent long-term consequences of neonatal pain. The hypothesis is that pre-emptive neonatal interventions that will decrease stress responses associated with painful neonatal procedures will also decrease adverse consequences later in life. To test this hypothesis, we first propose to examine whether neonatal cuddling (NC) around the time of injury can prevent the long-term effect of neonatal colon inflammation/pain in the adult rat. Second, we will show that neonatal cuddling (kangaroo care) will positively impact the health care outcomes of babies in the neonatal intensive care unit (NICU). The ability of these pre-emptive measures to reduce the long-term consequences in adults who were exposed to painful/stressful neonatal procedures has not been studied in either humans or animal models. To test the central hypothesis, three specific aims were designed. In specific aim 1, behavioral studies will be conducted to show that NC prevents the development of long-term visceral hypersensitivity in the adult rat with neonatal colon irritation, by reducing the stress associated with neonatal injury. In specific aim 2, stress-reduction techniques such as kangaroo care will be tested in the NICU to evaluate their benefits to premature infants who are in stable condition. The long-term consequences of neonatal trauma have been shown repeatedly to be detrimental to the individual in a number of clinical and basic studies. These studies have emphasized the immediate need to develop new preemptive care approaches in the clinical setting to lessen the impact of neonatal trauma. This proposal brings together a team of basic and clinical scientists, both established and in training, to evaluate the impact of stress-reduction techniques on the consequences of neonatal trauma. The studies proposed focus on one central hypothesis that will be tested in the laboratory and the clinic and highlight the high level of synergy among the investigators. If successful, these studies will enable us to generate additional data sufficient to broaden the scope of this proposal and to develop a multi-investigator R01 application. Furthermore, the results should have a positive impact on neonatal care and decrease long-term consequences in adults who were exposed to neonatal pain and stress.